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Despite changes to mandatory reporting obligations in 2018, many Australian doctors remain hesitant to seek treatment for mental health concerns, fearing they might be reported to the regulator. Dispelling this perception is vital to ensure doctors seek treatment when they need it.
One of the most common concerns we hear at Avant is that a treating doctor may be obligated to notify the regulator when their doctor-patient seeks mental health treatment. This fear is largely unfounded.
Across Australia, the threshold for a treating doctor to make a mandatory report about a doctor-patient is intentionally high.
In Western Australia, treating practitioners are completely exempt from making a mandatory notification (s141 of the Health Practitioner Regulation National Law [Western Australia] 2024).
In all other states and territories, a treating doctor is only required to notify a regulator if, during the course of treatment, they become aware that the doctor-patient:
- is practising their profession in a way that poses a substantial risk of harm to the public; or
- has engaged in, is engaging in or is at risk of engaging in sexual misconduct related to their professional practice.
As outlined in section 3 of the Guidelines: Mandatory notifications about registered health practitioners, both the Medical Board of Australia and the Australian Health Practitioner Regulation Agency (Ahpra) acknowledge that this is a high threshold for reporting by treating doctors. The intent behind this is clear: to ensure doctors can access treatment for mental health issues without fear of being reported.
Health condition is not the same as impairment
Another common concern for doctors arises during their renewal process when they fear acknowledging a mental health issue will be reported to the regulator. Again, this is a misunderstanding.
Each year, Avant hears from doctors who become concerned about their health when completing their registration renewal form because of the questions it asks about “impairment”.
The Health Practitioner Regulation National Law (Queensland) Act 2024 (s5) defines “impairment” as “a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect … the person’s capacity to practise the profession”.
Taken literally, any condition — even a headache — might detrimentally affect a person’s capacity to practise the profession. Understandably, such vague wording, repeated annually in renewal notices, can discourage doctors from disclosing mental health concerns.
Thankfully, the Medical Board of Australia has confirmed in section 2.3 of the Guidelines that a health condition — including a mental health condition — is not the same as an impairment. It is accepted that illness, including mental illness, which is treated and well managed, would rarely be considered an impairment requiring notification to the regulator.
Prioritise mental health and seek help
Doctors, like anyone else, are not immune to mental illness and the pressures we all experience in life. But they also face unique, high-pressure environments that can contribute to stress, burnout and psychological distress.
These pressures are compounded by fears about the regulatory notification process. In a 2023 report, Ahpra revealed that 16 health practitioners died by suicide and four others attempted suicide or self-harmed while involved in a notification complaints process within a four-year period.
These sobering statistics underline the urgent need for doctors to prioritise their health and seek help if they are suffering from stress, burnout, anxiety or depression. This principle has been incorporated into the Medical Board of Australia’s Good Medical Practice: Code of Conduct (clause 11.2.3).
Despite this guidance, doctors remain reluctant to seek treatment for mental health concerns, according to feedback provided to Avant and doctors health services.
Fortunately, organisations like the Black Dog Institute are responding to this reluctance, aiming to counter fears about mandatory reporting among health practitioners and establishing The Essential Network to provide critical mental health advice and wellbeing support to health care workers.
The National Doctors Health & Wellbeing Leadership Alliance is also taking coordinated action through the Every Doctor, Every Setting Framework to prevent mental ill-health and suicidal behaviour, and to support good mental health for all doctors and medical students.
Just as we are now dispensing with outdated judgements about mental health, it is time for doctors with mental health concerns to seek the care they need when it’s needed.
It is in all our interests to encourage them to do so without hesitation, stigma or fear.
Tracy Pickett is a legal and policy adviser at Avant Mutual. She is also a director of the AEIOU Foundation.
Professor Steve Robson is chief medical officer at Avant Mutual. He is also chair of the National Doctors Health & Wellbeing Leadership Alliance, professor of obstetrics and gynaecology at the Australian National University, and a council member of the National Health and Medical Research Council.
Conflict of interest statement: The authors are employed by Avant Mutual. Professor Robson is chair of the National Doctors Health and Wellbeing Leadership Alliance.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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